Reach Further - Kiana Rupe

Every year in the United States, nearly 150 million people of all ages participate in some form of sports activity. While numerous health benefits are associated with staying active, playing sports also carries the risk for injury. For 19-year-old Kiana Rupe, a goalkeeper with the St. Catharine College Patriots soccer team, this risk became a reality in October 2011.

"A girl on the other team had a breakaway, and once she entered the penalty box I came out for the ball and slid," Rupe said. "My hand got stuck on the ground while my arm stayed outstretched and my body kept going forward. I heard a loud popping noise and felt instant pain in my shoulder."

Rupe didn't know exactly what was wrong with her shoulder and, being a fierce and dedicated athlete, she continued playing.

"I thought maybe I just had a really swollen trapezius muscle. However, the more I played on it, the more it continued to hurt," Rupe said. "The pain got so bad that I really didn't want to do much of anything with it."

Rupe's shoulder began to get stiffer, and she started noticing that it would grind when she moved it or reached to catch the ball. Finally, the pain got so bad and her mobility was so limited that she decided to make an appointment with an orthopaedic sports health specialist.

"When Kiana came to me, she was experiencing all the common symptoms of shoulder instability," said Ryan J. Krupp, M.D., sports health and orthopaedic shoulder specialist. "Typically, when someone is suffering from shoulder instability, they can sometimes feel the ball of the shoulder come out of the socket and they have a lot of pain and stiffness."

While some shoulder instability patients can be treated with rest, ice and physical therapy, severe cases, like Rupe's, require surgery.

"We try to do everything we can to avoid surgery, especially when working with athletes," Dr. Krupp said. "However, if nonsurgical treatments do not correct the problem, we are forced to explore surgical options."

Rupe had shoulder surgery in December 2011 and started rehabilitation therapy a couple of days later. Her full recovery took about six months, and she is now training for her upcoming fall soccer season.

Is shoulder instability surgery right for you?Shoulder instability surgery may be the right choice for those who don't want to give up the activities or sports that aggravate their condition and those who experience instability at work or during routine daily activities such as dressing and sleeping.

The surgery includes examination of the shoulder under anesthesia to fully assess the extent and direction of the instability while the muscles surrounding the shoulder are completely relaxed. With cases of mild instability, an arthroscope is usually used to evaluate the inside of the shoulder joint and cartilage and to repair any damage that is found.

To correct severe instability, open surgery is often necessary. An incision is made over the shoulder, and the muscles are moved to gain access to the joint capsule, ligaments and labrum. Depending on the injury, the structures are repaired, reattached or tightened. The repair can be done using simple sutures or with sutures attached to metal or plastic, or to absorbable tacks or anchors. The anchors are inserted into the bone and hold the sutures that are used to reattach or tighten the ligaments. The anchors stay in the bone permanently.

Warning signs of a shoulder injury

Does your shoulder feel stiff?

Is it difficult to move your arm in all directions?

Does your shoulder feel like it could pop or slide out of the socket?

Is weakness in your shoulder preventing you from your daily activities?

See your physician if you answer yes to any of these questions or if you have recurring pain in your shoulder, neck or arm. Resist the urge to "play through" pain or ignore a loss of normal shoulder function, which can aggravate a shoulder injury and lead to more problems. Early intervention is one of the best forms of treatment.

Exercise to maintain healthy shouldersYou can help prevent shoulder injuries by staying physically fit with a balanced routine that includes aerobic exercise, stretching and strengthening all body parts. If you think you have injured your shoulder, consult a physician or physical therapist before starting an exercise program.

To prevent injury while exercising, try the following tips:

Apply heat to your shoulder muscles before you exercise. A warm 10- to 15-minute shower can help prepare muscles and tendons.